Important Notice about Prescription Drug Coverage and Medicare

Patient Protection and Affordable Care Act Disclosure

2017 Anthem Renewal Information

2017-18 Retiree Rates

There will be an Open Enrollment Period in effect from May 1 - May 31, 2018 for Board of Education employees eligible for participation in the Board of Education medical and dental insurance programs.

Employees who elected not to participate in these programs at the initial offering may enroll at this time. Employees may switch between the different insurance plans and may add dependents to their plans during this period. The effective date of these changes is July 1, 2018.

During the Open Enrollment period, informational meetings will be held when employees can ask questions about plan options and in particular, whether the High Deductible Health Plan (HDHP) with a Health Savings Account (HSA) makes sense for them. Representatives from our benefits advisor Arthur J. Gallagher & Co., CIGNA, and Employee Benefits Coordinator Terri Heintz will be on hand to discuss the highlights of the health plans and answer questions.

Scheduled meetings dates are:

• May 8th – Squadron Line School Library – 3:45 p.m.
• May 9th – Henry James Middle School Cafeteria – 2:30 p.m. and 4:00 p.m.
• May 14th – High School Auditorium – 2:30 p.m. and 4:00 p.m.

(Please note that there will be no health fair this year.)

Click on one of links below to view the 2018-19 plan benefit rates and for examples of out-of-pocket expenses by plan. If there are no changes to your health insurance coverage, you do not need to re-enroll for 2018-19.

CIGNA Rate Information - If there are no changes to your health insurance coverage, you do not need to re-enroll for 2018-19.

For rate information, please see the Medical Insurance tab.

The perfect attendance program as established July 1, 1986 provides for earning one-half day off with pay for pre-determined three-month periods of perfect attendance for eligible employees covered by the SFEP, NAME or unaffiliated agreements. Absences for personal leave or vacation leave will not mar perfect attendance; absences for sick leave, suspension or tardiness will mar perfect attendance. If you have had perfect attendance for the recorded period(s), please complete the form below and return it with the appropriate signatures to the Employee Benefits office.

Vacation Day Carry-over Request Forms:

• NAGE
• Unaffiliated
• SFEP

Absence Form (all-purpose)

Personal Day Codes/Guidelines

If you have questions regarding attendance records or would like to request an attendance report, e-mail your questions / requests to Terri Heintz, Employee Benefits Coordinator for Simsbury Public Schools.

• 2018-19 MetLife Dental Plan Rates
• Enrollment Form

MetLife 2018-19 Dental Insurance - If there are no changes to your dental insurance coverage, you do not need to re-enroll for 2018-19.

MetLife is the dental insurance plan carrier for Simsbury Public Schools. Dental services covered are divided into 4 categories:

MetLife Dental Claim Form
Group Policy No: 1656128 / 0305879
Dental Call Center Telephone 1-800-942-0854

Website: www.metlife.com/mybenefits

Members can use this link for a list of providers, verify eligibility, plan design and to review claim status or claim history. Employees must enter "Simsbury Board of Education" as the company name.

P.O. Box 981282
El Paso, TX 79998-1282

Take Our Couch to 5K Survey

Flu Clinic Consent 2017

Sept/Oct Evening Fitness Classes with Susan Rubenstein

The Simsbury Board of Education adopted this Plan effective January 1, 2000. The intention of the Board of Education is that the Plan qualifies as a “cafeteria plan” within the meaning of Section 125 of the Internal Revenue Code of 1986 allowing eligible employees to use tax-free dollars to pay for certain kinds of benefits and expenses.

The Patient Protection and Affordable Care Act (PPACA), signed into law in March 2010, states that beginning January 1, 2011, over-the-counter (OTC) drugs or medicines not prescribed by a doctor will no longer be reimbursable under a Flexible Spending Account.

Participation Fee (unchanged) - $5.85/month – Annual cost is $70.20.

Health Care Account Maximum Increase from $2,600 to $2,650 for 2018.

Metavante Benefits Card - The Flex Debit Card allows you to directly pay for your eligible flexible spending account expenses at the point of service. Manual claim reimbursements are also an option for eligible dependent or health care expenses.

Flex Grace Period Amendment - In an effort to ease the pain of the "use-it-or-lose-it" rule, the IRS has provided a two and one-half month grace period for amounts (called “temporary carry-over amounts) remaining in the flexible spending account (FSA) at the end of the plan. The grace period will not exceed the 15th day of the third month after the end of the Plan Year (i.e., two-and-a-half months).

Limited Purpose Flexible Spending Account – All benefit eligible employees with a Health Savings Account (HSA) are eligible to participate in the Limited Purpose Flexible Spending Accounts. Generally, any dental or vision expenses considered to be tax deductible by the IRS under IRC 213(d) can be reimbursed through the Limited Purpose Flexible Spending Account. The Limited Purpose Flexible Spending Account allows eligible employees to be reimbursed for certain dental and vision services (not covered by their medical plan) on a pre-tax basis. The result, through proper use of the plan, can be more money in your pocket!

Participation in the FSA Health Care account will impact your eligibility to a Health Savings Account (HSA). If you or your employer on your behalf, actively contribute to an HSA account, or your spouse contributes to an HSA, you may not participate in the FSA Health Care Account.

For more information, click on the links below:

• Memo from the Business Manager
• Notice of Open Enrollment for Flexible Spending Accounts
• General Information and Mobile App Instructions
• Eligible Expenses
• 2018 Enrollment Form
• 2018 Limited Purpose Enrollment Form
• 2018 Reimbursement Form

Flexible Spending Accounts / Payroll Dates 2018

20 Payrolls

(No deductions taken from 3^rd payroll in a month)
(No deductions taken during summer months – July and August)

• January 4 and 18
• February 1 and 15
• March 1 and 15
• April 12 and 26
• May 10 and 24
• June 6 and 21
• (No Deductions taken during July and August)
• September 13 and 27
• October 11 and 25
• November 8 and 21
• December 6 and 20

Health Care Reform - State Insurance Exchange / Marketplace

• Information from the SPS Business Manager
• New Health Insurance Marketplace Coverage Options and Your Health Coverage
• ***Important Information about the new Form 1095-C***

HIPPA Notice of Privacy Practices

Simsbury Notice of Privacy Practices:

As a requirement of the Health Insurance Portability and Accountability Act of 1996 (HIPAA) Privacy Regulation, the Simsbury Public Schools is required to provide you with a Notice of Privacy Practices. Under HIPAA guidelines, group health plans and flexible spending plans must notify participants about their Notice of Privacy Practices (NPP) at least once every three years. Simsbury Public Schools has distributed a copy of this notice to all participants. The complete copy of Simsbury Public Schools Notice of Privacy Practices is also available by clicking on the link below:

Simsbury Public Schools Notice of Privacy Practices

As explained in the complete privacy notice, Simsbury Public Schools is required by law to put in place reasonable measures that protect the privacy of your individually identifiable health information that is transmitted or maintained by the Plan in any form. This health information is considered protected health information (PHI). The type of health information maintained by Simsbury Public Schools includes the following: name, address, telephone number, birth date, names of relatives, social security number, e-mail address, fax number, income, health provider, physician notices, and copies of medical or dental claims. The NPP plan describes under what circumstances the Simsbury Public Schools may use and/or disclose health information about you and how you can access that information.

The NPP explains your rights to review copy or amend certain health information we have about you. The plan also outlines your rights to ask us to share your health information with certain individuals. The Authorization for Release of Health Information form [link not available] is available for personal requests.

THE DOCTORS TREATMENT CENTER of Granby will provide managed care services for all workplace injuries and illnesses.

A Medical Care Plan has been filed with and approved by the State of Connecticut Workers Compensation Commission. A network of quality medical providers that includes physicians, chiropractors, family/general practice, internal medicine, neurology, optometrists, physical /occupational therapists, orthopedic surgery, and radiology, all of whom are committed to providing prompt, efficient care.

Participation in the plan will be mandatory for all new injuries occurring on or after the effective date of the Medical Care Plan. The effective date of the Medical Care Plan is November 24, 2014.

Injured employees will be required to treat only with providers listed in the PPN. If treatment occurs outside the PPN, Workers' Compensation benefits shall be suspended (subject to the order of a Workers' Compensation Commissioner.)

You must immediately report all work-related injuries to your supervisor.

• If injured on the job - instructions
• 1st report of injury - form
• W/C Preferred Provide Network Notice
• W/C Notice to Employees
• CIRMA W/C Managed Care Program Employee Guide
• W/C Act Section 31-275 Definitions (link not available)
• Safety Committee Roster and Statement
• W/C Clarification Notice